Pro-Nurse Order Form


Fill out and then print the order form. Send check
(credit cards are now accepted Visa and Mastercard;
Order form will be updated shortly) with name and
complete address (UPS will not deliver to post office boxes) to:

ProNurse Products
15 Park Avenue
Gaithersburg, MD 20877
Phone: (301) 208-8060
Fax: (301) 208-8013

Email address:
Name:
Shipping Address:
Address
City,State,Zip:
Phone,Fax:
PO# if applicable:
Item/Description Unit PriceQuantity Total Price
Order SubTotal
Shipping and Handling
Order Total

Thank you for your order!

Include your phone number in case there are questions about your order. Be sure to include shipping charges (see chart below).

SHIPPING CHARGES:

  • For orders of: . . . . . . . . . Add
  • Up to $20.00 . . . . . . . . . $4.95
  • $20.00 to $40.00 . . . . . . $6.95
  • $40.00 to $60.00 . . . . . . $8.95
  • $60.00 to $80.00 . . . . . . $10.95
  • $80.00 to $100.00 . . . . . $12.95
  • $100.00 to $200.00 . . . . $16.95
  • Over $200.00 . . . . . . . . .9% of order